Remote RN Medical Reviewer

Job Summary

A company is looking for Remote Medical Case & Peer Reviewers (RNs & Certified Healthcare Professionals - 1099).

Key Responsibilities

• Conduct remote clinical case reviews focusing on medical necessity or standard of care
• Summarize clinical facts and provide clear, evidence-based determinations
• Collaborate with the team to ensure accuracy, timeliness, and compliance

Required Qualifications

• Active, unrestricted U.S. nursing or healthcare license (RN, LPN, or relevant clinical certification)
• At least 5 years of clinical experience (required for some case types)
• Ability to review cases objectively and meet turnaround deadlines
• Comfortable working independently in a secure, remote environment
• Experience with utilization review or medical necessity reviews preferred